PSYCHOLOGICAL DISTRESS, DEPRESSIVE SYMPTOMATOLOGY, COPING AND DSM-III-R ICD-10 PERSONALITY-DISORDERS - A STUDY AMONG PRIMARY MENTAL-HEALTH-CARE PATIENTS/

The association between psychological distress, coping and personality disorders (PDs) was studied among a group of 230 primary mental healt h care patients by means of Principal Component Analysis (PCA) and ste pwise multiple regression analyses. The PCAs revealed that those who s uffer from personality pathology tend to use passive coping and to be hostile and interpersonal sensitive. Those who show schizoid, schizoty pal, dissocial and avoidant traits tend not to seek social support. Th ose who show dependent and anxious traits tend to avoid difficult situ ations and not to express their (anger) feelings. The multiple regress ion analyses provided a more fine-grained analysis: hostility and inte rpersonal sensitivity appeared to be the strongest independent predict or of personality pathology. More particularly, hostility was high amo ng those scoring high on mainly the dramatic (B) cluster disorders, wh ereas interpersonal sensitivity appeared to be characteristic of patie nts from the eccentric (A), the dramatic (B) and the fearful (C) clust ers. In addition, PDs were characterised by the inability to handle st ress situations in an active way (mainly observed among disorders from the dramatic (B) and the fearful (C) clusters), an inability to use i nterpersonal relations in order to receive social support (mainly obse rved among disorders from the eccentric (A) and the dramatic (B) clust ers), and the use of passive coping, which was observed among disorder s from all three clusters. It is concluded that the assessment of symp tomatology and coping may provide the primary mental health care worke r with cues concerning the possible presence of personality pathology, which could then subsequently be investigated. This may have importan t implications for treatment; in cases of personality pathology, refer ral to secondary mental health care might be appropriate. (C) 1997 Els evier Science Ltd.